Health-related quality of life and self-reported cognitive function in patients with delayed neurocognitive recovery after radical prostatectomy: a prospective follow-up study

Abstract

Background Delayed neurocognitive recovery (DNCR) is a common and serious complication after radical prostatectomy. We hypothesized that patients with DNCR in the early postoperative period would report reduced health-related quality of life (HRQoL) and more cognitive failures 12 months after surgery, compared with patients without DNCR. Methods We performed a 12-month follow-up on 367 patients who had been enrolled in a prospective observational trial to study the incidence of DNCR after radical prostatectomy. Patients were screened for preoperative cognitive impairment and depression. We defined DNCR as a decline in cognitive function between days 3 and 5 after surgery, compared with baseline assessments. We evaluated HRQoL and cognitive failures 12 months after surgery with the 36-item Short Form Health Survey and the Cognitive Failures Questionnaire. General linear models were used to analyze associations of DNCR with HRQoL and cognitive failures. Results Delayed neurocognitive recovery in the early postoperative period was significantly associated with self-reported cognitive failures (B for no DNCR = − 0.411 [95% CI: − 0.798;0.024], p = 0.038), but not with physical (B = 0.082 [95% CI: − 0.021;0.186], p = 0.118) or mental HRQoL (B = − 0.044 [95% CI: − 0.149;0.062], p = 0.417) 12 months after surgery. Preoperative depression screening scores were significantly associated with self-reported cognitive failures and both physical and mental HRQoL 12 months after surgery. Conclusions Delayed neurocognitive recovery in the early period after radical prostatectomy has a long-term impact on patients’ daily lives by impairing memory, attention, action, and perception. Therefore, prevention of DNCR must be a priority for physicians and researchers. Consequent preoperative screening for depressive symptoms may facilitate early psycho-oncological intervention to improve postoperative HRQoL. Trials registrationDRKS00010014, date of registration: 21.03.2016, retrospectively registered.

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“…In recent years, dNCR has attracted attention because it causes economic and medical burdens, reduces quality of life, increases morbidity, and causes early mortality [ 4 , 5 ]. dNCR can have a long-term impact on patients’ daily lives by impairing memory, attention, activity, and perception [ 6 ]. Unfortunately, because the pathological mechanisms underlying dNCR have not been completely elucidated, there are presently no effective preventive or therapeutic strategies.…”

Quality of Life in Young Illicit Substance Abuser Men: Testing a Moderated Mediation Model of Age Related Decline in Executive Functions

“…Nonetheless, the evidence based on normal and diverse clinical samples supports the connection of EF with QoL as well as with psychological wellbeing in terms of emotional and social adjustment [19][20][21][22][23]. Presently, the studies are focusing on age related decline in EF and QoL in healthy aging adults on one hand [15], and on the EF-QoL link in healthy and clinical samples on the other hand [21,23]. However, evidence for the link between EF and QoL is lacking for samples of illicit substance abusers.…”

“…Yet, currently, there is little evidence regarding the association of EF with QoL in substance abuser population. Nonetheless, the evidence based on normal and diverse clinical samples supports the connection of EF with QoL as well as with psychological wellbeing in terms of emotional and social adjustment [19][20][21][22][23]. Presently, the studies are focusing on age related decline in EF and QoL in healthy aging adults on one hand [15], and on the EF-QoL link in healthy and clinical samples on the other hand [21,23].…”

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“…28 A recent study reported that those with delayed neurocognitive recovery between 3 and 5 days after surgery had more self-reported cognitive impairment in memory, attention, action, and perception at 12 month after radical prostatectomy. 29 It seems that patients with POCD have even worse outcomes. For example, studies found that patients with POCD at 3 months after surgery had twice the proportion of new impairment in activities of daily living when compared with those without 30 ; they also had a higher risk of long-term mortality.…”

“…For example, patients with cognitive decline 1 week after surgery are more likely to leave the labor market and depend on social transfer payment 28 . A recent study reported that those with delayed neurocognitive recovery between 3 and 5 days after surgery had more self‐reported cognitive impairment in memory, attention, action, and perception at 12 month after radical prostatectomy 29 . It seems that patients with POCD have even worse outcomes.…”